```

[Federal Register Volume 86, Number 135 (Monday, July 19, 2021)]
[Notices]
[Pages 38094-38095]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-15229]

=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-21-0212; Docket No. CDC-2021-0069]

Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

-----------------------------------------------------------------------

SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies the opportunity to comment on a proposed and/or 
continuing information collection, as required by the Paperwork 
Reduction Act of 1995. This notice invites comment on a proposed 
information collection project titled the National Hospital Care Survey 
(NHCS). The goal of the project is to assess patient care in hospital-
based settings, and to describe patterns of health care delivery and 
utilization in the United States.

DATES: CDC must receive written comments on or before September 17, 
2021.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2021-
0069 by any of the following methods:
     Federal eRulemaking Portal: Regulations.gov. Follow the 
instructions for submitting comments.
     Mail: Jeffrey M. Zirger, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE, MS-D74, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to Regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
portal (regulations.gov) or by U.S. mail to the address listed above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact Jeffrey M. Zirger, Information Collection 
Review Office, Centers for Disease Control and Prevention, 1600 Clifton 
Road NE, MS-D74, Atlanta, Georgia 30329; phone: 404-639-7118; Email: 
[email protected].

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), Federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. In addition, the PRA also requires 
Federal agencies to provide a 60-day notice in the Federal Register 
concerning each proposed collection of information, including each new 
proposed collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to the OMB for approval. To 
comply with this requirement, we are publishing this notice of a 
proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected;
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses; and
    5. Assess information collection costs.

[[Page 38095]]

Proposed Project

    National Hospital Care Survey (NHCS) (OMB Control No. 0920-0212, 
Exp. 03/31/2022)--Revision--National Center for Health Statistics 
(NCHS), Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Section 306 of the Public Health Service (PHS) Act (42 U.S.C. 
242k), as amended, authorizes that the Secretary of Health and Human 
Services (DHHS), acting through NCHS, shall collect statistics on the 
extent and nature of illness and disability of the population of the 
United States. This three-year clearance request for National Hospital 
Care Survey (NHCS) includes the collection of all inpatient and 
ambulatory Uniform Bill-04 (UB-04) claims data or electronic health 
record (EHR) data, as well as the collection of hospital-level 
information via a questionnaire from a sample of 608 hospitals.
    The National Ambulatory Medical Care Survey (NAMCS) was conducted 
intermittently from 1973 through 1985, and annually since 1989. The 
survey is conducted under authority of Section 306 of the Public Health 
Service Act (42 U.S.C. 242k). The National Hospital Discharge Survey 
(NHDS) (OMB No. 0920-0212, Exp. Date 01/31/2019), conducted 
continuously between 1965 and 2010, was the Nation's principal source 
of data on inpatient utilization of short-stay, non-institutional, non-
Federal hospitals, and was the principal source of nationally 
representative estimates on the characteristics of inpatients including 
lengths of stay, diagnoses, surgical and non-surgical procedures, and 
patterns of use of care in hospitals in various regions of the country. 
In 2011, NHDS was granted approval by OMB to expand its content and to 
change its name to the National Hospital Care Survey (NHCS).
    In May 2011, recruitment of sampled hospitals for the NHCS began. 
Hospitals in the NHCS are asked to provide data on all inpatients from 
their UB-04 administrative claims, or EHRs. Hospital-level 
characteristics and data on the impact of COVID-19 on the hospital are 
collected through an Annual Hospital Interview. NHCS will continue to 
provide the same national health-care statistics on hospitals that NHDS 
provided. Additionally, NHCS collects more information at the hospital 
level (e.g., volume of care provided by the hospital), which allow for 
analyses on the effect of hospital characteristics on the quality of 
care provided. NHCS data collected from UB-04 administrative claims and 
EHRs include all inpatient discharges, not just a sample. The 
confidential collection of personally identifiable information allows 
NCHS to link episodes of care provided to the same patient in the ED 
and/or OPD and as an inpatient, as well as link patients to the 
National Death Index (NDI) to measure post-discharge mortality, and 
Medicare and Medicaid data to leverage comorbidities. The availability 
of patient identifiers also makes analysis on hospital readmissions 
possible. This comprehensive collection of data makes future 
opportunities for surveillance possible, including analyzing trends and 
incidence of opioid misuse, acute myocardial infarction, heart failure 
and stroke, as well as trends and point prevalence of health care 
acquired infections and antimicrobial use.
    Beginning in 2013, in addition to inpatient hospital data, 
hospitals participating in NHCS were asked to provide data on the 
utilization of health care services in their ambulatory settings (e.g., 
EDs and OPDs). Due to low response rates and high level of missing 
data, OPD data were not collected in the last approval period (2019, 
2020 and 2021). Collection of OPD may resume in future years.
    Data collected through NHCS are essential for evaluating the health 
status of the population, for the planning of programs and policy to 
improve health care delivery systems of the Nation, for studying 
morbidity trends, and for research activities in the health field. 
There are no changes to the data collection survey. The only change is 
to the burden hours due to the increase of the sample size. The new 
total annualized burden is 7,184 hours.

                                                            Estimated Annualized Burden Hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                             Number of       Number of      burden per     Total burden
                  Respondents                                   Form name                   respondents    responses per   response (in     (in hours)
                                                                                                            respondent        hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Hospital DHIM or DHIT..........................  Initial Hospital Intake Questionnaire..             150               1               1             136
Hospital CEO/CFO...............................  Recruitment Survey Presentation........             150               1               1             136
Hospital DHIM or DHIT..........................  Prepare and transmit UB-04 or State                 408              12               1           4,896
                                                  File for Inpatient and Ambulatory
                                                  (monthly).
Hospital DHIM or DHIT..........................  Prepare and transmit EHR for Inpatient              200               4               1             800
                                                  and Ambulatory (quarterly).
Hospital CEO/CFO...............................  Annual Hospital Interview..............             608               1               2           1,216
                                                                                         ---------------------------------------------------------------
    Total......................................  .......................................  ..............  ..............  ..............           7,184
--------------------------------------------------------------------------------------------------------------------------------------------------------

Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-15229 Filed 7-16-21; 8:45 am]
BILLING CODE 4163-18-P
```